Association Between Carpal Tunnel Syndrome and Amyloid Heart Disease may Assist with Early Detection and Reduced Morbidity and Mortality

Carpal tunnel syndrome may help identify more systemic issues than previously thought. Multiple research studies establish an association between carpal tunnel syndrome and heart disease, most specifically cardiac amyloidosis. This link is of importance as it requires alternative treatment choices to extend life expectancy for those diagnosed with the disease. Based on this analysis of multiple studies, there may be an indication for a screening criterion in those with carpal tunnel syndrome to identify a previously illusive disease before it progresses. History and certain clinical features may add to the utility of this finding to be applied as a screening tool in the future

Antidepressant Use and Depressive Symptoms in Intensive Care Unit Survivors

Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. We examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana. Thirty-two percent (N = 65) of patients had depressive symptoms on initial CCRC visit. For patients who are not on an antidepressant at their initial CCRC visit (N = 135), younger age and lower education level were associated with a higher likelihood of having depressive symptoms. For patients on an antidepressant at their initial CCRC visit (N = 69), younger age and being African American race were associated with a higher likelihood of having depressive symptoms. Future studies will need to confirm these findings and examine new approaches to increase access to depression treatment and test new antidepressant regimens for post-ICU depression

It is all how you look at it: The relationship between performance appraisal formats and perceived purposefulness

Perceptions of performance appraisal fairness, accuracy, and purposefulness by employees is crucial in developing an effective performance appraisal system (Iqbal, Akbar, & Budhwar, 2015). Research suggests that rating accuracy and perceptions of fairness are of the greatest concern to organizations, however, there is minimal research regarding perceived purposefulness of the performance appraisal system. Additionally, there is a lack of literature looking at how manager perceptions of these factors relates to effective performance appraisal. In order to address these gaps in literature, the present study aims to examine how performance appraisal formats relate to managers’ perceived purposefulness of the performance appraisal system. The current study looks at data from a survey given to library directors at four-year academic institutions in which the participants provide details of their performance appraisal system and their opinions regarding the importance and effectiveness of the system. The responses will be analyzed to determine how the format used in performance appraisal systems relates to the perceived purposefulness of the system by library directors

The PFAS Health Study Focus Groups Research Protocol

This protocol sets out the methodology for the collection and analysis of data for the PFAS Health Study: Focus Groups Study.The Australian Government Department of Health has commissioned the Australian National University to undertake the PFAS Health Study

The PFAS Health Study Component One: Oakey, Williamtown and Katherine Focus Groups Study

This report details the findings from a series of focus group discussions held in Oakey (Qld), Williamtown (NSW), and Katherine (NT) between January and August 2018. The main aim of this study was to understand participants’ views and experiences of PFAS (per- and polyfluoroalkyl substances) contamination in their local area, with a focus on participants’ health concerns. Residents in these communities have been potentially exposed to PFAS chemicals. Potential exposure pathways varied between communities but include the use of contaminated water, including bore and river water on their properties, as well as town water. Less important potential exposure sources were eating locally produced foods and bush foods, through work activities, and in some instances through direct contact with firefighting foams. Four focus group discussions were held in each community, with 46, 36 and 29 participants attending in each of Williamtown, Oakey and Katherine respectively. One focus group discussion in each of the three communities was dedicated to Defence staff, contractors and family members. In Oakey, there were slightly more men than women, Williamtown focus groups contained roughly the same number of men and women, and in Katherine, there were predominately more women who attended the focus groups. Overall, the non-Aboriginal community groups contained slightly more people over the age of 50, more people who owned their own properties, and more who had lived in the area for longer than ten years. In Katherine, an additional three focus groups of 69 participants were held in local Aboriginal communities. The Aboriginal focus groups were larger, included more women who were often accompanied by children, and were held on community land. Participants voiced concerns related to their health and PFAS exposure. Children were considered more vulnerable due to their young age and exposure from growing up in affected areas. Participants were particularly concerned about the onset of cancers and the deterioration of existing health conditions. Another major concern for many participants was the stress and anxiety related to the duration of the PFAS contamination and uncertainty with respect to the long-term impact on health, specifically for their children. In addition to the above concerns, Aboriginal participants were also worried about the health of their children, contamination of river foods and bush tucker, and the overall impacts on country. Many participants were concerned about continuation of uncertainty and feeling unable to sell their property, being “stuck” in their community and lacking options to “move on”. Participants in the group discussions asked for greater transparency and consistency in the information they received. They discussed options that they thought would reduce their anxiety and provide information or pathways that could lead them out of their current situation soon. The findings from the focus group discussions have been used to contribute to the questionnaire design for a cross-sectional survey on health effects of PFAS. This report details the experiences and emotions of people who have been affected by the PFAS contamination.The Australian Government Department of Health has commissioned the Australian National University to undertake the PFAS Health Study

Relative rates of cancers and deaths in Australian communities with PFAS exposure.

Objectives The use of firefighting foam containing per- and polyfluoroalkyl substances (PFAS) has resulted in environmental contamination in three Australian communities. We examined whether people who had lived in these communities had higher rates of selected cancers and causes of deaths than those who had lived in comparison areas without known contamination. Approach The three exposure areas of interest were in Katherine (NT), Oakey (Qld) and Williamtown (NSW). We identified those who ever lived in exposure areas by linking street addresses in these areas to addresses collected in Medicare (1983-2019)—a consumer directory for Australia’s universal healthcare system. We also identified a sample of those who had lived in selected comparison areas. Exposed and comparison populations were then linked to Australia’s national cancer and death registries. We estimated standardised incidence ratios (SIRs) for 23 cancers, four causes of death and three control outcomes, adjusting for sex, age and calendar time of diagnosis. Results We observed higher rates of prostate cancer (SIR = 1·76, 95% confidence interval (CI) 1·36–2·24) in Katherine; laryngeal cancer (SIR = 2·71, 95% CI 1·30–4·98), kidney cancer (SIR = 1·82, 95% CI 1·04–2·96) and coronary heart disease (CHD) mortality (SIR = 1·81, 95% CI 1·46–2·33) in Oakey; and lung cancer (SIR = 1·83, 95% CI 1·39–2·38) and CHD mortality (SIR = 1·22, 95% CI 1·01–1·47) in Williamtown. We also saw elevated SIRs for control outcomes—outcomes not known or thought to be associated with PFAS exposure. SIRs for all other outcomes and overall cancer were similar across exposure and comparison areas. Conclusion There was limited evidence to support an association between PFAS exposure and risk of cancer. There was modest evidence of an association with CHD mortality, which merits further study given the links between PFAS and elevated blood lipids

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely